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Second-line combination chemotherapy with docetaxel and nedaplatin for metastatic or recurrent squamous cell carcinoma of the esophagus refractory to chemotherapy with 5-fluorouracil plus cisplatin

Ryohei Kawabata; Hiroshi Imamura; Tomono Kishimoto; Shinji Kitamura; Yoshimi Hachino; Yukako Yasui; Misako Fujino; Chika Fujii; Hiroshi Furukawa

Esophagus 8(3): 179-185

2011


ISSN/ISBN: 1612-9059
DOI: 10.1007/s10388-011-0277-5
Accession: 036132173

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There is no standard second-line chemotherapy regimen after failure of the standard 5-fluorouracil and cisplatin in the treatment of esophageal cancer. We retrospectively investigated the efficacy and toxicity of combination chemotherapy using docetaxel and nedaplatin for patients with metastatic or recurrent squamous cell carcinoma of the esophagus refractory to prior chemotherapy with 5-fluorouracil and cisplatin, and evaluated the prognostic significance of clinical factors in these patients. Patients received docetaxel (3 mg/m2 intravenously) on day 1 and subsequently nedaplatin (4 mg/m2 intravenously) on day 1 of each 2-week period thereafter. We analyzed the response rate, progression-free survival time, overall survival and toxicity in 3 patients treated with combination therapy using docetaxel and nedaplatin. characteristics at the time of initiating the combination chemotherapy were analyzed as prognostic factors. A median of four cycles (range 1 2) were administered to 3 patients. The median follow-up was 6.7 months (range .8 39.4). Of 27 patients with measurable lesions, 5 had a partial response, 1 had stable disease and 12 had progressive disease. The median progression-free survival and overall survival was 2.5 and 7.5 months, respectively. Grade 3 4 toxicities were leukocytopenia (13.3%), neutropenia (23.3%), anemia (23.3%), thrombocytopenia (3.3%), anorexia (6.6%) and fatigue (3.3%). Multivariate analysis revealed that the inflammation-based Glasgow prognostic score was an independent negative prognostic factor for overall survival. The combination chemotherapy with docetaxel and nedaplatin is a feasible and promising regimen as a second-line therapy in metastatic or recurrent esophageal cancer refractory to chemotherapy with 5-fluorouracil and cisplatin.

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